Why Do Movie Stars Have Beautiful Skin

I am going to ignore the obvious answers which are true in part: they have facials very often; they pamper themselves; the smart ones and the older ones get enough sleep; the smart ones eat well; they airbrush their pictures!
What they have, either through youth or the magic of cosmetic surgery, is full faces. Their faces are rounded and their cheeks are full.
Many years ago cosmetic surgeons noticed that when we did fat augmentation on facial cheeks and eyes the skin of the patients became smoother and softer. Wrinkles stretched out and disappeared. The obvious answer was that transplanted fat contained stem cells which regenerated the skin. Studies from numerous sources confirmed that fat did contain a relatively high percentage of stem cells and these cells could be harvested in studies of tissue regeneration.
Let me digress for a moment. Collagen came to market some 20 or so years ago. It was described as lasting 3-4 months. In working with patients I found that repeated small injections over a series of weeks stretched the duration of improvement from injected collagen to years. Arnold Klein (verbal communication) said he had the same results. When hyaluronic acid came to market it was said to last 6 months. Two years ago I found that using hyaluronic acid in the cheeks of my wife lasted more than 1 1/2 years. Repeated experience with many of my patients revealed that hyaluronic acid lasted 2 years or more when injected in the face above the upper lip. Presumably this was due to the small amount of animation of facial muscles above the nose. Then histologic evidence proved that hyaluronic acid does last several years in the face and now restylane and juvaderm both claim duration of filling to last 1 or more years.
Now, back from my digression. I have been filling the cheeks and eyes with hyaluronic acid and calcium based microspheres (Radiesse) in more and more patients and in patient after patient not only are the facial proportions restored toward youth, their skin softens and becomes smoother. Wala! Maybe it isn't stem cells in fat that restore skin to former texture and appearance. Maybe it is the simple act of filling the envelope back to fullness that rejuvenates overlying facial skin.
This is a potential breakthrough. Now we can control the envelope with tightening procedures that regenerate collagen and we can also restore healthy, youthful skin appearance by filling out sunken cheeks and eyes. I wonder how this will work in necks ...
Edward B. Lack, MD http://www.metropolitanmds.com/